tbuckley/cabot-search huggingface dataset:
AB0055 BONE AND MINERAL DISORDERS IN RENAL HEMODIALYSIS PATIENTS
Authors: R. Ben Tekaya, H. Hachfi, M. Brahem, O. Jomaa, Z. Atti, Y. Mohamed
Journal: Annals of the Rheumatic Diseases (2022)

Background Chronic kidney disease causes many mineral and bone disorders, secondary hyperpathyroidism, adynamic bone disease and osteomalacia which can reduce the bone mineral density (BMD). Objectives To analyze the prevalence of osteoporosis in group of patients with chronic renal failure and to evaluate the relation between bone mineral density (BMD) and specific markers of bone turnover in hemodialysis (HD) population. Methods This is a cross sectional study conducted in rheumatology department of Taher Sfar university hospital in mahdia, Tunisia. The study involved 61 patients with chronic hemodialysis. they were invited to participate and were included after signing informed consent until the calculated sample size was reached. Patients were asked to undergo a hip and lumbar (L2-L4) densitometry by DXA to measure bone mineral density (BMD). Serum levels of iPTH and alkaline phosphatase (ALP) were measured before the dialysis session. Results The studied group of 61 patients was 26 females (42,6%) and 35 males (57.4%), there mean age was 53.9 [17-83] years, with mean dialysis duration 6,1 years. The mean onset age of hemodialysis therapy was 44.7 +/- 15.4 years. It was diabetic nephropathy in 25 cases (41%) vascular nephropathy in 15 cases and tubulointerstitial nephropathy in 21 cases (34,4). 23 patients (37,7%) had osteoporosis using the WHO criteria (T-score &lt; -2,5), 26 patients (42,6%) had osteopenia and 12 patients had normal BMD. The mean serum level of iPTH with normal BMD and lower BMD 167,84 vs 535,71 respectively. the mean serum level of ALP with normal BMD and lower BMD 144,59 vs 271,99 respectively (p&lt;0,001). The mean duration of dialysis therapy with normal BMD and lower BMD 4,57 years vs 6,55 years (p&lt;0,001). Conclusion Our study showed that osteoporosis is common in dialysis patients. The main determinants of BMD is PTH activity and the duration of dialysis therapy. the importance of prevention and treatment of metabolic bone disease has become better appreciated. Disclosure of Interests None declared
AB0299 ASSOCIATION OF RHEUMATOID CACHEXIA WITH DISEASE PARAMETERS IN MOROCCAN RHEUMATOID ARTHRITIS PATIENTS
Authors: M. Mahroug, H. Azzouzi, I. Linda
Journal: Annals of the Rheumatic Diseases (2022)

Background Low muscle mass occurs in patients with rheumatoid arthritis without weight loss. This condition has been studied lately (1) and was referred to as rheumatoid cachexia (RC). Objectives To study the prevalence of rheumatoid cachexia and its associated factors in rheumatoid arthritis (RA) patients. Methods We designed a cross-sectional study on RA patients recruited from December 2021 at our rheumatology department. Exclusion criteria were patients with prior chronic kidney disease, severe heart failure, severe chronic obstructive pulmonary disease, acute liver failure, uncontrolled diabetes, thyroid dysfunction, dysphagia, illicit drug use, and alcohol abuse. Body composition was measured with dual-energy X-ray absorptiometry (DXA), and patients’ data were collected. RC was defined by Engvall et al. (2) as a fat-free mass index (FFMI) below the 10th percentile (under lean) and a fat mass index (FMI) above the 25th percentile (fat excess). Inflammatory activity was measured by C-reactive protein (CRP) and used to assess disease activity score for 28 joints (DAS28CRP). The physical disability was assessed by the Health Assessment Questionnaire (HAQ) and the physical activity by the International Physical Activity Questionnaire (IPAQ). Nutrition was evaluated by the Mini Nutritional Assessment (MNA). Results We included 91 RA patients with a mean age of 52.61 ± 12.99 years. The prevalence of rheumatoid cachexia was 12.1 %. Twenty-six patients (28.6 %) were under lean, and six patients (6.6 %) had excess fat. DAS28CRP (p = 0.004) and fasting glucose (p = 0.03) were significantly lower in RC patients. RC did not show any significant association with HAQ, MNA, physical activity, gender, menopause, seropositivity, lipid levels or BMI. RC was significantly associated with DAS28CRP (p = 0.01, OR = 0.305, 95%IC [0.114, 0.818]) and fasting glucose level (p = 0.02, OR = 0.0002, 95%IC [0.00000001, 0.311]) when adjusting on IPAQ categories and ACPA seropositivity. Conclusion Rheumatoid cachexia was frequent in our RA patients. This condition was significantly associated with low fasting blood sugar levels and disease activity. References [1]Santo RC, Silva JM, Lora PS, Moro ALD, Freitas EC, Bartikoski BJ, et al. Cachexia in patients with rheumatoid arthritis: a cohort study. Clin Rheumatol. dec 2020;39(12):3603‑13. [2]Engvall I-L, Elkan A-C, Tengstrand B, Cederholm T, Brismar K, Hafstrom I. Cachexia in rheumatoid arthritis is associated with inflammatory activity, physical disability, and low bioavailable insulin-like growth factor. Scand J Rheumatol. oct 2008;37(5):321‑8. Disclosure of Interests None declared
AB1076 IS THERE AN ADDITIONAL IMPACT OF STIMULATING CD8+ LYMPHOCYTES TO DETECT LATENT TUBERCULOSIS IN PATIENTS WITH RHEUMATIC DISEASES?
Authors: Z. Özsoy, A. Özdemir, M. Ekici, A. Eken, F. Çakmak, E. Bilgin, L. Kiliç, A. İ. Ertenli, Z. Saribaş, O. Karadag, B. Şener
Journal: Annals of the Rheumatic Diseases (2022)

Background Purified protein derivative skin test (PPD) or interferon gamma release assays (IGRAs) are used as diagnostic tools to detect latent tuberculosis. QuantiFERON-TB Gold Plus (QFT-Plus) is a new test that detects latent tuberculosis. Antigens of Mycobacterium tuberculosis (ESAT-6 and CFP-10) are used. The test contains two tubes: TB1 and TB2. TB1 tube contains peptides of these antigens that induce CD4+T cell response while TB2 tube contains peptides designed to stimulate both CD4+ and CD8+ T cells. The amount of interferon gamma releases from those cells are determined by ELISA method. In patients with recent exposure to tuberculosis, there is an increased amount of CD8+ expression in comparison to patients with past exposure to tuberculosis. Objectives To investigate the additional impact of stimulating CD8+ lymphocytes with QFT-Plus test in order to detect latent tuberculosis in patients with inflammatory rheumatic diseases. Methods Hacettepe University Rheumatology Biologic Registry Database (HURBIO) database was used in this study. QFT-Plus test of patients with rheumatoid arthritis (RA) and spondyloarthritis (SPA) between January 2018 and March 2021 during work up before biologic/targeted therapy were analysed, retrospectively. Positivity of any of tubes has been reported as QFT (+). The impact of each tube on QFT positivity is analysed. Results 1480 patients (946 (64%) SPA, 534 (36%) RA) were enrolled. 957 patients were women. The median age was 45 (min-max:18-82). Totally 12.2% of patients had been reported as QFT(+). In 6% of QFT (+) patients only TB2 tube is positive (Table 1). Table 1. The impact of each tube on QFT-Plus positivity QFT-Plus test (n=1480) Negative 86.2% Indeterminate 1.5% Positive Only TB1 tube positivity 8% of positively reported patients 12.2% of all patients Only TB2 tube positivity 6% of positively reported patients TB1 and TB2 positivity 86% of positively reported patients Conclusion Disease inflammatory cascades along with ongoing usage of immunosuppressive agents could affect results of QFT-plus assay in rheumatic diseases. TB2 tubes stimulating CD8(+) T lymphocytes have additional impact in detecting latent TB infection in patients with RA and SpA. Disclosure of Interests None declared
AB1544-HPR CLINICAL COMORBIDITY PHENOTYPE IN KNEE OSTEOARTHRITIS IS ASSOCIATED WITH HIGHER INTENSITY SCORES
Authors: A. Ben Tekaya, O. Hamdi, L. Rouached, S. Bouden, R. Tekaya, O. Saidane, I. Mahmoud, L. Abdelmoula
Journal: Annals of the Rheumatic Diseases (2022)

Background Knee osteoarthritis (OA) is a common osteoarticular disease. Its prevalence increases with age as well as the coexistence of other chronic diseases. Recent researches have revealed an association between OA and cardiovascular diseases. However, association between knee OA and comorbidities has not been fully studied. Objectives The purpose of this study was to investigate the association between knee OA and comorbidities. Methods In this cross-sectional study, patients with knee OA were enrolled. Sociodemographic data as well as comorbidities were collected. Grading of knee OA was performed using the Kellgren-Lawrence (KL) grading system. Functional impact of knee OA was assessed by KOOS-Physical Function Shortform (KOOS-PS). Results This study assessed 104 patients with knee OA (10 men and 94 women). Mean age was 65.83 ±11.08 years. Mean VAS pain was 6.56 ± 1.72. Mean KOOS-PS was 15.58 ± 6.73. Up to 81 patients (77.9%) had severe knee OA according to the KL grading system. Comorbidity was noted in 92 cases (88%). The most frequent comorbidities were obesity (62.5%), hypertension (61.5%) and dyslipidemia (43.3%). Comorbidities in knee OA were associated with age (p=0.04), neuropathic pain component (p=0.02) and VAS pain (p=0.04). Our study also showed a significant correlation between comorbidities and structural grading of knee OA (p=0.04). However, comorbidities were not correlated with KOOS-PS score (p=0.06). Conclusion The accumulation of comorbidities is significantly associated with higher intensity scores in knee OA. Physicians should additionally pay close attention to the prevention and the treatment of comorbidities in the management of OA. Disclosure of Interests None declared
AB0225 FRAX ASSESSMENT IN PATIENTS WITH RHEUMATOID ARTHRITIS PREDICTED THE REAL INCIDENCE OF CLINICAL FRACTURES FOR 10 YEARS FROM THE RESULTS OF THE 10-YEAR TOMORROW STUDY
Authors: K. Mamoto, T. Koike, T. Okano, Y. Sugioka, M. Tada, K. Inui, H. Nakamura
Journal: Annals of the Rheumatic Diseases (2022)

Background To investigate if FRAX in patients with RA can predict the incidence of new clinical fractures for 10 years by using the 10-year data of the TOMORROW study (UMIN000003876) which is a prospective cohort study. Objectives To investigate if FRAX in patients with RA can predict the incidence of new clinical fractures for 10 years by using the 10-year data of the TOMORROW study (UMIN000003876) which is a prospective cohort study. Methods We calculated ten-year probability of major osteoporotic fracture (FRAX) in 208 RA patients and 205 sex- and age-matched volunteers (Vo), and compared FRAX with the incidence of clinical fractures for 10 years. Results The mean FRAX were 14.5 and 8.8% in 175 RA patients and 168 Vo, respectively, in whom we could calculate FRAX at baseline and complete to investigate the incidence of clinical fractures for 10 years from baseline. The mean FRAX in RA patients was significantly higher than that in Vo (P&lt;0.001). The actual incidence of clinical fractures for 10 years in RA patients was significantly higher than that in Vo (33.9 vs 22.9%, P=0.031). In both groups, the actual incidence of clinical fractures was higher than FRAX prediction. Logistic regression analysis revealed that FRAX and FRAX≧15% were the significant risk factors for clinical fractures for 10 years in both groups (Odds ratio (OR), 1.055, P&lt;0.001, 2.943, P=0.043, respectively). The mean FRAX in RA patients with and without clinical fractures for 10 years were 18.5 and 12.5%, respectively (P=0.002). In RA patients, FRAX was also the significant risk factor for clinical fractures (OR, 1.046, P=0.004). Conclusion FRAX and the incidence of clinical fractures for 10 years were significantly higher in RA patients than them of Vo. We confirmed that FRAX was the risk factor for clinical fractures in actual clinical practice. Disclosure of Interests None declared
The fight against malaria: Diminishing gains and growing challenges
Authors: Justin M. Cohen, Fredros Okumu, Bruno Moonen
Journal: Science Translational Medicine (2022)

Since the year 2000, historic reductions in malaria incidence and mortality have been driven by the widespread distribution of bed nets, drugs, and insecticides for the prevention and treatment of malaria. Scale-up of these tools has been enabled by an increase in malaria financing compounded by price reductions, yet these trends are unlikely to continue at the same rate. Rapid population growth in high-endemic areas requires procurement of more of these tools just to maintain current coverage, even as prices are likely to increase as resistance to drugs and insecticides forces shifts to newer products. Further progress toward the long-term goal of malaria eradication requires a combination of greater funding, more cost-effective resource allocation, and fundamental changes to the global malaria control strategy.
AB0703 The need for anti-osteoporotic therapy in patients with systemic sclerosis
Authors: A. Sorokina, N. Demin, O. Dobrovolskaya, N. Toroptsova
Journal: Annals of the Rheumatic Diseases (2022)

Objectives To determine the need for anti-osteoporotic therapy in postmenopausal women and men over 50 years of age with systemic sclerosis (SSc). Methods The study included 150 patients with SSc who met the ACR/EULAR 2013 criteria: 124 (82,7%) postmenopausal women and 26 (17.3%) men over 50 years of age. Median age was 59,0 [54,0; 64,0] years. The duration of the disease was 8,0 [5,0; 14,5] years. A history of fragility fractures was collected. FRAX was calculated in patients without prior fractures to identify patients at high risk of low-energy fractures. Dual-energy X-ray densitometry (DXA) was performed in persons at moderate risk of fractures, and 10-year probability of major osteoporotic fractures was recalculated with the inclusion of a hip neck T-score. DXA was also performed on all patients from the low-risk group who had 2 or more risk factors of OP. Results 36 (24%) patients had a history of fragility fractures: 21 (16.9%) women and 6 (4.3%) men - vertebrae fracture, 8 (6.5%) women - peripheral fractures, 1 (3.8%) man – hip fracture. The calculation of the 10-year probability of fractures by FRAX showed that 21 (16,9%) women had a high risk, and another 60 women and 3 men had moderate risk of fractures. After the FRAX recalculation with the inclusion of the femoral neck T-score, only 26 (21,0%) women moved from the moderate-risk group to the high-risk group. All men and 48 women had a low risk of osteoporotic fractures according to FRAX, among them 12 (8,0%) people (4 men and 8 women) had osteoporosis by DXA. Thus, among SSc patients 84 (67.7%) women and 11 (42,3%) men needed anti-osteoporotic treatment. Conclusion As a result of a comprehensive assessment of the risk of fractures and OP, it was found that 63.3% of patients with SSc needed anti-osteoporotic treatment. Disclosure of Interests None declared
Targeted radiotherapy for early-stage, low-risk pediatric Hodgkin lymphoma slow early responders: a COG AHOD0431 analysis
Authors: Akash Parekh, Frank G. Keller, Kathleen M. McCarten, Sandy Kessel, Steve Cho, Qinglin Pei, Yue Wu, Sharon M. Castellino, Louis S. Constine, Cindy L. Schwartz, David Hodgson, Kara M. Kelly, Bradford S. Hoppe
Journal: Blood (2022)
AB1448 DEEP VENOUS THROMBOSIS IN YOUNG ADULTS: INCIDENCE AND RISK FACTORS
Authors: F. Nabli, S. Daadaa, Y. Boussoukaya, I. Chaabene, M. Kechida, R. Klii, S. Hammami
Journal: Annals of the Rheumatic Diseases (2022)

Background After a first venous thromboembolic (VTE) episode, recurrence is frequent and associated with significant morbidity and mortality. Objectives Our aim is to identify the risk factors for recurrent VTE in young subjects and to assess the risk-benefit ratio of continuing long-term anticoagulant treatment. Methods We carried out a retrospective study including 100 patients with deep vein thrombosis (DVT) admitted to the Internal Medicine Department at Fattouma Bourguiba University Hospital in Monastir between 2011 and 2020. Results In our study, the gender ratio was 1.17. The mean age was 34.49 years ± 9.19. Lower extremity deep venous thrombosis (LEDVT) was the most common location (90%). Pulmonary embolism (PE) was found in 8% of cases. The most frequent risk factors were obesity: BMI&gt;30 (40%), bed rest (20%), personal history of DVT (18%), smoking (16%), recent surgery dating less than one month (14%), and recent trauma (12%). The etiological assessment had concluded to inherited thrombophilia in 41 cases: protein S deficiency (23%), protein C deficiency (8%), activated protein C resistance (8%), and antithrombin III deficiency (2%); acquired thrombophilia in 28 cases: hyperhomocysteinemia (HH) in 19 cases and antiphospholipid syndrome (APLS) in 9 cases; Behçet’s disease in 10 cases and systemic lupus erythematosus in 5 cases. No cases of neoplasia were detected. The treatment was based on low molecular weight heparin (LMWH), relayed by vitamin k antagonists (VKAs), and physical therapy (graduated compression stockings and early mobilization). Duration of the treatment of DVT in the young adult depends on the nature and extent of the thrombosis, the underlying risk factors, and etiologies. Among the 100 hospitalized patients, recurrent DVT was detected in 20% of cases: 17% of patients reported a history of DVT with a mean number of previous episodes of 2, and only 3% developed DVT during their follow-up. The mean time to recurrence was three years. Recurrence was located on the same side in most cases (70%). In our study, only Behçet’s disease was associated with an increased risk of DVT recurrence (p: 0.015, OR: 5.46, CI [1.38-21.56]). Gender, age, venous insufficiency, and bed rest had no significant influence on the risk of recurrence (p&gt;0.05). Conclusion Young adults should be assessed for acquired and also genetic factors, which would suggest extending the duration of anticoagulant therapy in high-risk patients, reducing the incidence of post-thrombotic syndrome and VTE recurrence. Further studies are needed to evaluate the association of Behçet’s disease with DVT recurrence. Disclosure of Interests None declared
POS1516-HPR CHRONIC INFLAMMATORY RHEUMATISMS: DOES PERIODIC FASTING REDUCE THE DISEASE ACTIVITY?
Authors: O. Hamdi, S. Jemmali, W. Kammoun, S. Boussaid, S. Rahmouni, S. Rekik, H. Sahli, M. Elleuch
Journal: Annals of the Rheumatic Diseases (2022)

Background Many experimental studies have emphasized the role of periodic fasting in the adaptive responses that reduce inflammation. Objectives Our purpose was to assess the impact of periodic fasting on the activity of chronic inflammatory rheumatisms (CIR). Methods We conducted a cross-sectional study involving patients with rheumatoid arthritis (RA) (2010 ACR/EULAR criteria) and spondyloarthritis (SpA) (2009 ASAS criteria). CIR activity was assessed during the period of Ramadan (periodic fasting) and three months following Ramadan using clinical parameters including the Patient’s Global Assessment of disease activity (PGA), 10-cm Visual Analog Scale (VAS) pain score, morning stiffness, nocturnal awakenings, and joint count for RA (tender joint count (TJC) and swollen joint count (SJC)); biological parameters including C-reactive protein (CRP); disease activity scores including the SDAI, CDAI and DAS 28 CRP for RA, BASDAI and ASDAS CRP for SpA. An analysis of variance (ANOVA) was used to assess the statistical relationship between fasting and CIR activity. Results We enrolled 75 patients (40 RA and 35 SpA) with a sex ratio of 0.4 and a mean age of 55.35 ± 9.81 years [22-85]. The mean chronic CIR duration was 11.85 ± 3.4 years. RA was erosive in 92% of cases. Rheumatoid factor and anti-citrullinated peptides antibodies were positive respectively in 82% and 84% of cases. Seventy-five percent of RA patients were on corticosteroids with a mean dose of 10.20 mg/day of prednisone equivalent, and 81% of SpA patients were on non-steroidal anti-inflammatory drugs. Eighty-three percent of our patients were treated with conventional synthetic DMARD, and 40% with biological DMARD. The following parameters were lower in the month of Ramadan compared to the period following Ramadan in RA patients: mean PGA 4.3 vs 4.6 (p=0.01); mean morning stiffness 1.1 vs 1.5 (p=0.01); mean SJC 4.7 vs 8.5 (p=0.01); mean DAS 28 CRP 3.56 vs 4.25 (p= 0.05); mean CDAI 17.5 vs 20.35 (p= 0.01), and mean SDAI 13.87 vs 18.44 (p=0.01). As for SpA, the following parameters were lower in the month of Ramadan compared to the period following Ramadan: mean morning stiffness 1.3 vs 2.1 (p= 0.01); mean ASDAS CRP 2.9 vs 3.3 (p= 0.01), and mean BASDAI 3.6 vs 4.9 (p= 0.05). However, we found no statistically significant correlation between periodic fasting and VAS pain score, nocturnal awakenings, TJC, and CRP. Conclusion Our study concluded that periodic fasting was associated to a lower CIR activity. The incorporation of periodic fasting may promote optimal health and reduce the activity of some chronic inflammatory diseases. Disclosure of Interests None declared
AB1263 CHRONIC RECURRENT MULTIFOCAL OSTEOMYELITIS IN CHILDREN: A SINGLE CENTER 10-YEAR EXPERIENCE.
Authors: A. Nargizyan, S. Kurbanova, A. Glazyrina, E. Korobyants, V. Yusupova, A. Sologub, E. Zholobova
Journal: Annals of the Rheumatic Diseases (2022)

Background Chronic recurrent multifocal osteomyelitis (CRMO) is a chronic autoinflammatory disease that primarily affects the skeleton in the absence of an infectious etiology in children and adolescents. It is an orphan disease with many unclear aspects in terms of diagnosis, treatment and follow-up. Objectives To report demographic, clinical and laboratory characteristics of a single center cohort of CRMO patients in Morozovskaya Children’s City Clinical Hospital in Moscow, Russia. Methods We retrospectively and prospectively reviewed clinical records of 33 CRMO patients diagnosed between 2011 and 2021 and admitted to Rheumatology Department of Morozovskaya Children’s City Clinical Hospital. Results We identified 33 patients with CRMO. Twenty-five (75%) were female. Median age of symptoms onset was 9 [6;12] years. Median delay in diagnosis was 12 month. All patients had bone pain as an initial symptom; fever has been present in 12 patients (63%). Joints involvement was observed in 22 patients (67%) – 39%, 18%, 12%, and 3% of patients had ankle, hip, knee, and shoulder and wrist joints involvement, respectively. All patients had multifocal bone lesions, which were confirmed by radiological methods (CT scan, MRI, scintigraphy). Vertebrae (42.4%) and femur (48.5%) were the most commonly affected bones. One child had a skull lesion (os parietale). Eleven patients (33%) also had sacroiliitis. Other organs involvement was observed 7 patients presented with palmoplantar pustulosis and psoriasis. Histopathological examination has been performed in 24 (73%) patients to confirm the diagnosis. Mean ECR was 43 [28;80] mm/h and CRP – 27 [15;61] mg/L. Twenty-three (69,6%) patients had immunological activity. Conclusion From our experience, most of the patients had delay in diagnosis. Laboratory tests showed mild elevation of inflammatory parameters. Seven (21%) patients had psoriasis. Disclosure of Interests None declared